Eye Clinic of Luigi Sacco Hospital, University of Milan, Milan, Italy.
Invest Ophthalmol Vis Sci. 2012 Jun 26;53(7):3999-4004. doi: 10.1167/iovs.11-9258.
To evaluate differences in fluorescein angiography (FA) and indocyanine green angiography (ICGA), findings between subjects affected by Stargardt disease (STGD) and atrophic AMD.
This was a consecutive, cross-sectional case series. A total of 24 eyes of 12 patients with STGD and 23 eyes of 14 patients with atrophic AMD were enrolled in the study. Patients underwent dynamic simultaneous FA and ICGA using a dual beam confocal scanning system. Images were recorded from the initial filling of choroidal and retinal vessels throughout all the phases of the angiogram. Spectral-domain optical coherence tomography (SD-OCT) and fundus autofluorescence were also executed. FA and ICGA findings in the two groups were evaluated.
In 92% (22/24) of eyes affected by STGD, ICGA showed hypocyanescence from the areas of atrophy, more evident in the late phases. This finding, defined as ICGA-imaged "dark atrophy," was present in only 13% (3/23) of the eyes affected by atrophic AMD. The remaining eyes in both groups showed iso- or mild hypercyanescence from the areas of atrophy. Eyes with ICGA-imaged dark atrophy, both in STGD and in atrophic AMD groups, did not show early obscuration of the choroidal vessels by FA. SD-OCT revealed morphologically intact choroid in STGD patients with ICGA-imaged dark atrophy. In atrophic AMD eyes with ICGA-imaged dark atrophy, SD-OCT revealed a severely thinned choroid.
Hypocyanescence by ICGA from the areas of atrophy was more frequent in STGD compared with atrophic AMD. This finding, along with SD-OCT evidence of intact choroid, suggests a possible selective damage of the choriocapillaris in STGD.
评估患有斯塔加特病（STGD）和萎缩性年龄相关性黄斑变性（AMD）的患者之间荧光素血管造影（FA）和吲哚菁绿血管造影（ICGA）的差异。
这是一项连续的、横断面病例系列研究。共纳入 12 例 STGD 患者的 24 只眼和 14 例萎缩性 AMD 患者的 23 只眼。患者使用双光束共焦扫描系统进行动态同步 FA 和 ICGA。从脉络膜和视网膜血管的初始填充开始，在整个血管造影的所有阶段记录图像。还进行了光谱域光学相干断层扫描（SD-OCT）和眼底自发荧光检查。评估两组患者的 FA 和 ICGA 结果。
在 92%（22/24）只患有 STGD 的眼中，ICGA 显示从萎缩区域呈现弱荧光，在晚期更为明显。这种发现被定义为 ICGA 成像的“暗萎缩”，仅在 13%（3/23）只患有萎缩性 AMD 的眼中出现。两组其余的眼睛从萎缩区域呈现等或轻度强荧光。在 STGD 和萎缩性 AMD 组中均出现 ICGA 成像暗萎缩的眼睛，FA 并未早期遮蔽脉络膜血管。SD-OCT 显示在 STGD 患者中，ICGA 成像的暗萎缩区存在形态完整的脉络膜。在萎缩性 AMD 患者中，ICGA 成像的暗萎缩眼，SD-OCT 显示脉络膜严重变薄。
与萎缩性 AMD 相比，ICGA 从萎缩区域呈现的弱荧光在 STGD 中更为常见。这一发现以及 SD-OCT 显示脉络膜完整的证据表明，STGD 中可能存在脉络膜毛细血管的选择性损伤。
